title: Drug development in preeclampsia: a 'no go' area?
abstract: Drug development in pregnancy and particularly in preeclampsia has been long neglected. Preeclampsia is a leading cause of maternal mortality, and early-onset preeclampsia can result in serious long-lasting consequences to the neonate. Many treatments have been trialed with varying success including vitamin supplementation, low-molecular-weight heparins, and aspirin. In this commentary, we particularly focus on the current status of drugs in development specifically aimed at preeclampsia. We outline the current understanding of the causes of the endothelial dysfunction seen in preeclampsia and, as such, potential therapeutic targets. With treatment of preeclampsia being largely unchanged in decades, there is an urgent need for novel therapies particularly those directed at the underlying causes that may allow for extremely preterm delivery, and its myriad consequences, to be avoided.
authors.affiliation: Department of Fetal Medicine, Box 228, The Rosie Hospital, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 2SW United Kingdom.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Everett
authors.forename: Ian B
authors.initials: IB
authors.lastname: Wilkinson
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Lees
mesh_terms: D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D009569:Nitric Oxide / Q000096:biosynthesis; D052250:Nitric Oxide Synthase Type III; D010879:Piperazines / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011687:Purines / Q000627:therapeutic use; D026422:S-Nitrosoglutathione / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D042461:Vascular Endothelial Growth Factor A; D009569:Nitric Oxide; D026422:S-Nitrosoglutathione; D000068677:Sildenafil Citrate; D052250:Nitric Oxide Synthase Type III